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Reversible Cerebral Vasoconstriction Syndrome Secondary to Escitalopram
Matthew Postolowski1, Omair Shakil1, Lintu Ramachandran2
1Department of Neurology, Baylor College of Medicine, Houston, Texas.
Clinical Medicine & Research
|February 24, 2025
Summary
Reversible cerebral vasoconstriction syndrome (RCVS), a neurological emergency, can be triggered by SSRI antidepressants. Prompt treatment with calcium channel blockers can significantly improve symptoms in RCVS patients.
Area of Science:
- Neurology
- Pharmacology
Background:
- Reversible cerebral vasoconstriction syndrome (RCVS) is an underdiagnosed neurological condition.
- Selective serotonin reuptake inhibitors (SSRIs) are potential secondary causes of RCVS.
Purpose of the Study:
- To present a case of RCVS secondary to escitalopram use.
- To highlight the diagnostic and management considerations for RCVS.
Main Methods:
- Case report of a young woman with RCVS.
- Review of RCVS risk factors, mechanisms, presentation, diagnostics, and management.
- Treatment with intra-arterial calcium channel blockers.
Main Results:
- The patient presented with bilateral neurological deficits.
- RCVS was diagnosed in the context of long-term escitalopram use.
- Symptoms improved significantly after intra-arterial calcium channel blocker treatment.
Conclusions:
- RCVS should be considered in patients with thunderclap headache, particularly those using SSRIs.
- Early diagnosis and treatment are crucial for managing RCVS.
- Intra-arterial calcium channel blockers can be effective in treating RCVS.
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